Hospital-acquired conditions and length of stay in the pregnancy and puerperal cycle

• Autor(a) principal: Alexandra Dias Moreira
• Data de Publicação: 2019
• Outros Autores: Ariene Silva do Carmo, Juliana Fantini Chaves Pereira, Larissa Loures Mendes, Fernanda Penido Matozinhos, Milene Cristine Pessoa, Thales Philipe Rodrigues da Silva, Luna Cosenza, Taiane Gonçalves Novaes
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.11606/s1518-8787.2019053000688; http://hdl.handle.net/1843/59820; https://orcid.org/0000-0002-4477-5241; https://orcid.org/0000-0002-3421-9495; https://orcid.org/0000-0001-5934-7453; https://orcid.org/0000-0002-0031-3862; https://orcid.org/0000-0003-1368-4248; https://orcid.org/0000-0002-1053-5450; https://orcid.org/0000-0002-7115-0925; https://orcid.org/0000-0001-6040-2499; https://orcid.org/0000-0002-9180-5490
• topic: Pregnant women; Puerperal disorders; Hospitalization; Length of stay; Economics; Hospital Costs; Gestantes; Transtornos puerperais; Hospitalização; Tempo de internação; Economia hospitalar; Custos hospitalares

OBJECTIVE: To analyze the impact of the Hospital-Acquired Conditions (HAC) in women inthe puerperal and pregnancy cycle during length of stay.METHODS: This cross-sectional study was conducted with 113,456 women, between July2012 and July 2017, in Brazil’s national hospitals of the supplementary healthcare networks andphilanthropists accredited to the Unified Health System (SUS). Data on hospital dischargeswere collected using the Diagnosis-Related Groups (DRG Brasil) system. All DRGs of themajor diagnostic category 14 (MDC14), including pregnancy, childbirth and puerperium, wereincluded. The impact of HAC on length of stay was estimated by Student’s t-test, and the effectsize by Cohen’s d, which allows to assess clinical relevance.RESULTS: Th e m ost p revalent d iagnostic c ategories r elated t o M DC14 w ere v aginal a ndcesarean deliveries without complicating diagnoses, both at institutions accredited to SUSand those for supplementary health care. The prevalence of HAC was 3.8% in supplementaryhealth and 2.5% in SUS. Hospitals providing services to supplementary health care providershad a longer length of stay considering HAC for patients classified as DRG: cesarean sectionwith complications or comorbidities at admission (p < 0.001; Cohen’s d = 0.74), cesarean sectionwithout complications or comorbidities at admission (p < 0.001, Cohen’s d = 0.31), postpartumand post abortion without listed procedure (p < 0.001, Cohen’s d = 1.05), and other antepartumdiagnoses with medical complications (p < 0.001; Cohen’s d = 0.77).CONCLUSIONS: This study showed that the prevalence of HAC was low both in the institutionsaccredited to attend by SUS and in those of supplementary health; however, its presencecontributes to increasing the length of stay in cases of cesarean sections without complicationsor comorbidities in supplementary health institutions.